▶ Cobicistat is predicted to increase the exposure to
is predicted to increase the exposure to gefitinib.
potentially increases the exposure to glecaprevir.
▶ Cobicistat is predicted to moderately to markedly increase the
exposure to grazoprevir. Avoid.rStudy
▶ Cobicistat is predicted to increase the exposure to guanfacine.
Adjust guanfacine dose, p. 352.oStudy
▶ Cobicistat is predicted to very markedly increase the exposure
to ibrutinib. Avoid potent inhibitors of CYP3A4 or adjust
is predicted to increase the exposure to imatinib.
▶ Cobicistat is predicted to increase the risk of toxicity when
given with irinotecan. Avoid.oStudy
▶ Cobicistat is predicted to increase the exposure to ivabradine.
▶ Cobicistat is predicted to increase the exposure to ivacaftor.
Adjust ivacaftor p. 293 or lumacaftor with ivacaftor p. 294 or
tezacaftor with ivacaftor p. 295 dose with potent inhibitors of
▶ Cobicistat is predicted to increase the exposure to lapatinib.
▶ Cobicistat is predicted to markedly increase the exposure to
▶ Cobicistat is predicted to increase the exposure to lurasidone.
is predicted to increase the exposure to macitentan.
▶ Cobicistat markedly increases the exposure to maraviroc. Refer
to specialist literature.rStudy
potentially increases the exposure to mexiletine.
▶ Cobicistat is predicted to markedly to very markedly increase
the exposure to midazolam. Avoid or adjust dose.rStudy
▶ Cobicistat is predicted to very markedly increase the exposure
to midostaurin. Avoid or monitor for toxicity.rStudy
▶ Cobicistat is predicted to increase the exposure to mirabegron.
Adjust mirabegron dose in hepatic and renal impairment,
is predicted to increase the exposure to mirtazapine.
▶ Mitotane is predicted to decrease the exposure to cobicistat.
▶ Cobicistat is predicted to increase the exposure to modafinil.
▶ Cobicistat is predicted to increase the exposure to monoclonal
antibodies (trastuzumab emtansine). Avoid.rTheoretical
▶ Cobicistat is predicted to markedly increase the exposure to
is predicted to increase the exposure to netupitant.
▶ Nevirapine is predicted to decrease the exposure to cobicistat.
▶ Cobicistat is predicted to moderately increase the exposure to
▶ Cobicistat is predicted to increase the exposure to nitisinone.
BNF 78 Cobicistat — Cobicistat 1431
▶ Cobicistat is predicted to increase the exposure to olaparib.
Avoid potent inhibitors of CYP3A4 or adjust olaparib dose,
▶ Cobicistat is predicted to increase the exposure to opioids
(alfentanil, buprenorphine, fentanyl, oxycodone, sufentanil).
Monitor and adjust dose.rStudy
▶ Cobicistat is predicted to increase the exposure to ospemifene.
Avoid in poor CYP2C9 metabolisers.oStudy
▶ Cobicistat is predicted to increase the exposure to oxybutynin.
▶ Cobicistat is predicted to increase the exposure to palbociclib.
Avoid or adjust palbociclib dose, p. 992.rStudy
▶ Cobicistat is predicted to increase the exposure to
panobinostat. Adjust panobinostat dose; in hepatic
impairment avoid, p. 936.oStudy
▶ Cobicistat is predicted to increase the exposure to paritaprevir.
▶ Cobicistat is predicted to increase the exposure to pazopanib.
Avoid or adjust pazopanib dose, p. 993.oStudy
▶ Cobicistat is predicted to increase the exposure to
phosphodiesterase type-5 inhibitors (avanafil, vardenafil). Avoid.
▶ Cobicistat is predicted to increase the exposure to
phosphodiesterase type-5 inhibitors (sildenafil). Avoid potent
inhibitors of CYP3A4 or adjust
▶ Cobicistat is predicted to increase the exposure to
phosphodiesterase type-5 inhibitors (tadalafil). Use with caution
▶ Cobicistat is predicted to increase the exposure to pimozide.
▶ Cobicistat is predicted to slightly increase the exposure to
▶ Cobicistat is predicted to increase the exposure to quetiapine.
▶ Cobicistat is predicted to increase the exposure to ranolazine.
▶ Cobicistat is predicted to increase the exposure to reboxetine.
▶ Cobicistat is predicted to increase the exposure to regorafenib.
is predicted to increase the exposure to repaglinide.
▶ Cobicistat is predicted to increase the exposure to retinoids
Avoid or adjust ribociclib dose, p. 997.oStudy
▶ Rifabutin decreases the concentration of cobicistat and
cobicistat increases the exposure to rifabutin. Avoid or adjust
▶ Rifampicin is predicted to decrease the exposure to cobicistat.
▶ Cobicistat is predicted to increase the exposure to risperidone.
▶ Cobicistat is predicted to increase the exposure to rivaroxaban.
▶ Cobicistat is predicted to increase the exposure to ruxolitinib.
Adjust dose and monitor side effects.oStudy
is predicted to increase the exposure to saxagliptin.
▶ Cobicistat is predicted to increase the concentration of
▶ Cobicistat is predicted to increase the exposure to solifenacin.
Adjust solifenacin p. 779 or tamsulosin with solifenacin p. 786
dose; avoid in hepatic and renal impairment.rStudy
▶ Cobicistat is predicted to moderately increase the exposure to
SSRIs (dapoxetine). Avoid potent inhibitors of CYP3A4 or
adjust dapoxetine dose, p. 821.rStudy
▶ St John’s Wort is predicted to decrease the exposure to
cobicistat. Avoid.rTheoretical
▶ Cobicistat is predicted to increase the exposure to statins
(atorvastatin). Avoid or adjust dose and monitor
▶ Cobicistat is predicted to increase the exposure to statins
▶ Cobicistat is predicted to slightly increase the exposure to
sunitinib. Avoid or adjust sunitinib dose, p. 999.oStudy
▶ Cobicistat is predicted to increase the concentration of
tacrolimus. Monitor and adjust dose.rStudy
▶ Cobicistat is predicted to increase the exposure to taxanes
▶ Cobicistat is predicted to moderately increase the exposure to
taxanes (docetaxel). Avoid or adjust dose.rStudy
▶ Cobicistat is predicted to increase the exposure to taxanes
▶ Cobicistat is predicted to increase the concentration of
temsirolimus. Avoid.rTheoretical
▶ Cobicistat is predicted to increase the exposure to tezacaftor.
Adjust tezacaftor with ivacaftor p. 295 dose with potent
▶ Cobicistat is predicted to markedly increase the exposure to
▶ Cobicistat is predicted to increase the exposure to tofacitinib.
Adjust tofacitinib dose, p. 1105.oStudy
▶ Cobicistat is predicted to increase the exposure to tolterodine.
▶ Cobicistat is predicted to increase the exposure to tolvaptan.
Manufacturer advises caution or adjust tolvaptan dose with
potent inhibitors of CYP3A4, p. 669.rStudy
is predicted to increase the exposure to toremifene.
▶ Cobicistat is predicted to increase the exposure to trabectedin.
Avoid or adjust dose.rTheoretical
▶ Cobicistat is predicted to moderately increase the exposure to
trazodone. Avoid or adjust dose.oStudy
▶ Cobicistat is predicted to slightly increase the exposure to
tricyclic antidepressants.nStudy
▶ Cobicistat is predicted to increase the exposure to ulipristal.
Avoid if used for uterine fibroids.rStudy
▶ Cobicistat is predicted to increase the exposure to
▶ Cobicistat is predicted to increase the exposure to venetoclax.
Avoid or adjust dose—consult product literature.rStudy
is predicted to increase the exposure to venlafaxine.
▶ Cobicistat is predicted to increase the exposure to vinca
▶ Cobicistat is predicted to increase the exposure to vitamin D
substances (paricalcitol).oStudy
▶ Cobicistat is predicted to increase the exposure to zopiclone.
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to cobimetinib.rTheoretical
▶ Antiepileptics (carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone) are predicted to decrease the exposure
to cobimetinib. Avoid.rTheoretical
▶ Antifungals, azoles (fluconazole, isavuconazole, miconazole,
posaconazole) are predicted to increase the exposure to
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to markedly increase the exposure to cobimetinib.
Avoid or monitor for toxicity.rStudy
▶ Aprepitant is predicted to increase the exposure to
▶ Bosentan is predicted to decrease the exposure to cobimetinib.
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to cobimetinib.rTheoretical
▶ Cobicistat is predicted to markedly increase the exposure to
cobimetinib. Avoid or monitor for toxicity.rStudy
is predicted to increase the exposure to cobimetinib.
▶ Efavirenz is predicted to decrease the exposure to cobimetinib.
1432 Cobicistat — Cobimetinib BNF 78
▶ Enzalutamide is predicted to decrease the exposure to
cobimetinib. Avoid.rTheoretical
▶ Grapefruit juice is predicted to increase the exposure to
cobimetinib. Avoid.rTheoretical
▶ HIV-protease inhibitors are predicted to markedly increase the
cobimetinib. Avoid or monitor for toxicity.r
▶ Idelalisib is predicted to markedly increase the exposure to
cobimetinib. Avoid or monitor for toxicity.rStudy
is predicted to increase the exposure to cobimetinib.
▶ Macrolides (clarithromycin) are predicted to markedly increase
cobimetinib. Avoid or monitor for toxicity.
▶ Macrolides (erythromycin) are predicted to increase the
exposure to cobimetinib.rTheoretical
▶ Mitotane is predicted to decrease the exposure to cobimetinib.
▶ Netupitant is predicted to increase the exposure to
▶ Nevirapine is predicted to decrease the exposure to
cobimetinib. Avoid.rTheoretical
is predicted to increase the exposure to cobimetinib.
▶ Rifampicin is predicted to decrease the exposure to
cobimetinib. Avoid.rTheoretical
▶ St John’s Wort is predicted to decrease the exposure to
cobimetinib. Avoid.rTheoretical
▶ Antiarrhythmics (dronedarone) are predicted to increase the
exposure to colchicine. Adjust colchicine dose with moderate
inhibitors of CYP3A4, p. 1120.rStudy
▶ Antifungals, azoles (fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure to colchicine. Adjust
dose with moderate inhibitors of CYP3A4, p. 1120.
▶ Antifungals, azoles (itraconazole, ketoconazole, voriconazole) are
predicted to increase the exposure to colchicine. Avoid potent
inhibitors of CYP3A4 or adjust
▶ Apalutamide is predicted to decrease the exposure to
▶ Aprepitant is predicted to increase the exposure to colchicine.
Adjust colchicine dose with moderate inhibitors of CYP3A4,
▶ Calcium channel blockers (diltiazem, verapamil) are predicted to
increase the exposure to colchicine. Adjust colchicine dose
with moderate inhibitors of CYP3A4, p. 1120.rStudy
is predicted to increase the exposure to colchicine.
▶ Ciclosporin increases the exposure to colchicine. Avoid or
adjust colchicine dose, p. 1120.rStudy
▶ Cobicistat is predicted to increase the exposure to colchicine.
Avoid potent inhibitors of CYP3A4 or adjust colchicine dose,
▶ Crizotinib is predicted to increase the exposure to colchicine.
Adjust colchicine dose with moderate inhibitors of CYP3A4,
▶ Eliglustat is predicted to increase the exposure to colchicine.
Avoid or adjust colchicine dose, p. 1120.rTheoretical
▶ Colchicine increases the risk of rhabdomyolysis when given
▶ HIV-protease inhibitors are predicted to increase the exposure
to colchicine. Avoid potent inhibitors of CYP3A4 or adjust
colchicine dose, p. 1120.rStudy
▶ Idelalisib is predicted to increase the exposure to colchicine.
Avoid potent inhibitors of CYP3A4 or adjust colchicine dose,
▶ Imatinib is predicted to increase the exposure to colchicine.
Adjust colchicine dose with moderate inhibitors of CYP3A4,
▶ Lapatinib is predicted to increase the exposure to colchicine.
Avoid or adjust colchicine dose, p. 1120.oTheoretical
▶ Macrolides (azithromycin) are predicted to increase the
exposure to colchicine. Avoid or adjust colchicine dose, p. 1120.
▶ Macrolides (clarithromycin) are predicted to increase the
exposure to colchicine. Avoid potent inhibitors of CYP3A4 or
adjust colchicine dose, p. 1120.rStudy
▶ Macrolides (erythromycin) are predicted to increase the
exposure to colchicine. Adjust colchicine dose with moderate
inhibitors of CYP3A4, p. 1120.rStudy
▶ Mirabegron is predicted to increase the exposure to colchicine.
▶ Netupitant is predicted to increase the exposure to colchicine.
Adjust colchicine dose with moderate inhibitors of CYP3A4,
▶ Nilotinib is predicted to increase the exposure to colchicine.
Adjust colchicine dose with moderate inhibitors of CYP3A4,
▶ Pibrentasvir (with glecaprevir) is predicted to increase the
▶ Pitolisant is predicted to decrease the exposure to colchicine.
▶ Ranolazine is predicted to increase the exposure to colchicine.
Avoid or adjust colchicine dose, p. 1120.rTheoretical
is predicted to increase the exposure to colchicine.
▶ Colchicine increases the risk of rhabdomyolysis when given
is predicted to increase the exposure to colchicine.
▶ Vemurafenib is predicted to increase the exposure to
. Avoid or adjust colchicine dose, p. 1120.r
Colecalciferol → see vitamin D substances
SEPARATION OF ADMINISTRATION Manufacturer advises take
4 hours before, or after, other drugs.
SEPARATION OF ADMINISTRATION Manufacturer advises take
other drugs at least 1 hour before, or 4 hours after, colestipol.
SEPARATION OF ADMINISTRATION Manufacturer advises take
other drugs at least 1 hour before, or 4–6 hours after,
Colistimethate → see TABLE 2 p. 1375 (nephrotoxicity), TABLE 20 p. 1379
(neuromuscular blocking effects)
Combined hormonal contraceptives
▶ Combined hormonal contraceptives are predicted to increase
the exposure to agomelatine.oStudy
▶ Combined hormonal contraceptives are predicted to increase
aminophylline. Adjust dose.o ▶ Combined hormonal contraceptives are predicted to increase
the exposure to anagrelide.oTheoretical
▶ Antiepileptics (carbamazepine, eslicarbazepine, fosphenytoin,
oxcarbazepine, perampanel, phenobarbital, phenytoin,
primidone, rufinamide, topiramate) are predicted to decrease
the efficacy of combined hormonal contraceptives. For FSRH
guidance, see Contraceptives, interactions p. 794.rStudy
▶ Combined hormonal contraceptives alter the exposure to
antiepileptics (lamotrigine). Adjust dose.oStudy
▶ Aprepitant is predicted to decrease the efficacy of combined
hormonal contraceptives. For FSRH guidance, see
Contraceptives, interactions p. 794.rStudy
▶ Bosentan is predicted to decrease the efficacy of combined
hormonal contraceptives. For FSRH guidance, see
Contraceptives, interactions p. 794.rStudy
▶ Brigatinib decreases the exposure to combined hormonal
. Use additional contraceptive precautions.
▶ Oral combined hormonal contraceptives potentially decrease
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